Critical Illness Claim, ICICI Pru Heart / Cancer Protect Claim, Major Surgical Assistance Benefit Rider Claim, Accidental Death Benefit Rider or other Rider Claim

To report a claim you will need the following documents:

• Claimant's statement / claim intimation form
• Attending doctor's certificate
• Copy of medical records (admission notes, discharge summary and test reports)
• Cancelled cheque

Fixed benefit hospitalisation claim for ICICI Pru Hospital Care or ICICI Pru Hospital Care II

You will receive a sum as Fixed Benefit* for the number of days you were admitted in a hospital or type of surgery grade under the ICICI Pru Hospital Care and Hospital Care II policies. For reporting Fixed Benefit Hospitalisation claim, you will need the following documents:

• Claimant's statement / claim intimation form
• Copy of medical records (admission notes, discharge summary and test reports)
• Pre-authorisation form (for cashless facility)
• Attending doctor's certificate
• Health check-up form (for ICICI Pru Hospital Care II)
• Cancelled cheque

Indemnity Hospitalisation Claim applicable for ICICI Pru MediAssure or ICICI Pru Health Saver:

For the expenses made for hospitalisation and other related medical costs*, you will be compensated under the Indemnity Hospitalisation claim. For reporting this claim, you will need the following documents:

• Claimant's statement / claim intimation form
• Original discharge card
• Original investigation reports
• Health check-up form (for ICICI Pru Health Saver)
• Original hospital/ pharmacy bills and payment receipts and records
• Pre-authorisation form (for cashless facility)
• Health saving benefit form (for ICICI Pru Health Saver)
• Cancelled cheque

*Please read your policy document for further details.
**A rider is an extra benefit that can be purchased along with your policy for increasing your cover. Comp/doc/Jan/2018/0777.

^{^} COMP/DOC/May/2021/55/5712